Improving the Quality and Efficiency of Emergency Care Across the Continuum: A Systems Approach American College of Emergency Physicians Abstract In June 2006, the Institute of Medicine (IOM) Committee on the Future of Emergency Care in the United States Health System released three reports that outline a pathway to improved emergency medical care for U.S. citizens. A key area of focus in the reports is the need to improve our emergency care research infrastructure and productivity. In response to the IOM recommendations, the American College of Emergency Physicians (ACEP) proposes a one-day conference titled Improving the Quality and Efficiency of Emergency Care Across the Continuum: A Systems Approach that will bring together a diverse group of healthcare stakeholders for a one-day consensus conference to be held in Boston, MA on October 4, 2009. The goal of this conference is to determine how the processes of care delivery in the emergency care system can be designed and used more effectively to provide solutions to quality and efficiency problems present in the United States healthcare system. Conference participants will come together to critically examine the interface between the emergency department (ED) and other core components of the health care delivery system, to explore the role of the ED in improving patient care, and to look 'downstream'at ways to improve the quality, safety, efficiency and effectiveness of care across the healthcare continuum. Research priorities will be set so that interactions between the ED, hospital, and outpatient settings are optimized, especially where value is added and waste is minimized. In looking expansively and creatively, this conference will help clarify how patient flow, information management, communication and transitions can be improved in ways that will be beneficial to patients, caregivers, and payers. The conference will seek to better understand the core competencies of the current emergency care system, to identify how these can be leveraged to improve healthcare in general, and to prioritize research questions that require further study and intervention. The timing is right for this conference, as new technology is being implemented in the healthcare system and imperatives to optimize value are a priority. In considering the entire continuum of care, and not just focusing on ED treatment in isolation, much opportunity exists to identify high impact, creative solutions to the nation's healthcare problems. A white paper delineating the conference recommendations will be issued to AHRQ and submitted to a peer-review journal to help design and prioritize research funding programs that will ultimately improve patient care in this country. American College of Emergency Physicians